therapy san diego

Cognitive Defusion: How Thanking Your Mind for Its Worst Thoughts Can Help You Get Some Distance

By Annabelle Mebane, MA, AMFT

In Acceptance and Commitment Therapy, the overall goal of our work is to help clients increase what we call psychological flexibility, which is basically the ability to do what matters most to you in your life no matter what uncomfortable thoughts and feelings show up.

One of the skills we teach to help people respond more effectively to their thoughts is called “Cognitive Defusion.”

Our default mode is to take our thoughts at face value and to believe that they are true and important. Like a fish doesn’t know it’s in water, we don’t typically notice that we are thinking. We are so accustomed to looking out the lens of our own thoughts that we forget to recognize we’re wearing glasses at all, and that there might be more than one way to see things.

Cognitive defusion is the ability to notice that we are having a thought

that our mind is “languaging” about our experience. Defusion involves creating a little bit of space that allows us to recognize that just because our mind thought it, doesn’t necessarily make it true or important. Why should we make that space? Because if we can recognize a thought for what it is – words our mind is generating – we can make a choice about how we want to respond to it. Instead of automatically buying into our thoughts or viewing them as directives or imperatives, we can tune in to our values – who and how we most hope to be in a given moment – and decide whether listening to a particular thought and behaving accordingly is going to move us toward or away from our valued direction.

There are a whole bunch of exercises

that we use in ACT to help you learn how to defuse from your thoughts. One of them goes like this. First, you state the thought exactly as your mind has it. For example, “if I go out on this date, I’m going to embarrass myself.” Then you pause, and notice what it’s like to sit with the thought. Next, you preface the thought with “I’m having the thought that…[thought]”, and notice what it’s like to sit with that. Finally, you preface it with “I’m noticing that I’m having the thought that….”, and tune in to what that’s like.

And then you can decide, do you want to listen to that thought, and stay home and avoid the possibility of being embarrassed because it feels more comfortable? Or are you someone who wants to be open, vulnerable, and show up anyways because it’s meaningful to you to try to find a fulfilling connection, even if it’s a risk?

Notice that when we are ‘defusing,’ we aren’t getting caught by the content of the thought, trying to prove or disprove it.

We are simply creating enough distance to allow us to choose how we want to respond.

But here’s the thing, sometimes it feels pretty hard to get that distance and to make a choice based on values.

Why? Because sometimes, or maybe even usually, the stickiest and most painful thoughts our minds have are designed to try to protect us from something painful. And probably, it kind of works. If we continue with the above example, your mind might be trying to protect you from the pain of rejection or disconnection. And yeah, if you stay home, you get the relief of know you can’t embarrass yourself and you can’t get rejected. But the thing is, if you avoid going out on any dates because you might get rejected or feel embarrassed, you are almost certainly also going to miss out on the possibility of a really meaningful connection.

The thing about pain is that it doesn’t show up around stuff that doesn’t matter to us; it shows up around the things that we care most deeply about.

On the flip side of our pain, we can usually find our most cherished values.

Your mind comes up with these painful stories to try to prevent you from feeling pain or loss around the things that matter to you, but a lot of times, when we listen to those stories, that’s what keeps us from accessing the richness of moving toward what really matters.

So for those especially sticky thoughts that seem so powerful and that are really deeply painful, sometimes the best defusion tactic is pretty counterintuitive.

Instead of beating yourself up for having such self-critical thoughts, you can actually thank your mind. You can thank it for trying to help you and for trying to protect you, and then you can let it know that you are going to take it from here.

It sounds nuts to thank your mind for telling you that you are weird or a failure or incompetent or unworthy or too sensitive, but when we meet our pain with compassion, understanding that our minds are just trying their best to do their job and keep us safe, we sometimes can start to take away the power of that really painful story and get just enough space from it to decide to respond based on something other than the avoidance of pain.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

A Lesson on Living Life to Its Fullest

by Shoshana Shea, Ph.D.

“You must defeat your reason before you can start” – Patrick Star

If you want to live life to the fullest, it’s not about forgetting all your troubles and checking out, it’s about slowing down, checking in, and recognizing you have choices. One of the greatest examples of this came from the imagination of Stephen Hillenburg, “SpongeBob Squarepants” show creator, and his writers. The character is Larry the Lobster; the name of the episode, “A Life in a Day.” As I watched that episode for the 100th time, I was thinking more about Larry’s secret to living life to the fullest; he pronounces, “You got to take risks. Live on the edge…by living each day like it was your last.” Larry goes on to say, “By livin’ like, me, Larry!” 

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Living life to the fullest does NOT mean that we should try to ignore all our fears and worries.

Patrick The Starfish, states, “This is the moment where we redeem our miserable lives,” and decides that he must live moment to moment and find the most dangerous of feats; then he will truly be living! To Patrick, ‘Living life to the fullest’ seems to mean that we should try to forget reality and just live without regard for the long-term consequences. I think many of us can relate to that idea, that we wish to live completely free of fear and shut off our worries like a faucet. If only it were that easy! Patrick pronounces, “You must defeat your reason before you can start.” This is my absolute favorite line! It can sound so appealing to ignore that voice in our head that urges us to be cautious and go the opposite direction. But as appealing as it might sound to have no fear, as Patrick discovers, this can have pretty big consequences.

Cautious isn’t necessarily the same as stagnant or boring…

While Patrick is out thrill-seeking within inches of his life, Spongebob interprets living a full life to mean not taking any risks at all. He embodies that voice in our head that tells us to stay firmly planted inside our comfort zone. That familiar voice which can paralyze us, and which can make life stagnant, boring, and small.

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Moving towards our values is not easy; otherwise we’d all be doing it!

When we are heading in a direction that is deeply meaningful to us (TOWARDS our values), we have to remember that the short-term is usually not easy at all. When we are moving AWAY from our valued direction, the short-term is usually a relief and can be enthralling at first. What we later find out is, ultimately, an AWAY move reveals that the hard stuff is still there and there are usually negative consequences to whatever method of avoidance we chose in the first place: Drinking excessively, overeating, acting impulsively, reckless thrill seeking (like Patrick), or staying well within our comfort zone (like Spongebob), etc. 

Mindfulness is a useful tool to help us move towards are values.

Mindfulness is often misunderstood to mean that we are only “allowed” to be in the present moment, and not think too much, or to not think at all, about the future. Being mindful is about non-judgmentally NOTICING and having awareness of what we are thinking, feeling, and experiencing, while we are in the present moment. For example, if we are aware that we are feeling sad about our work situation, we can notice the physiological sensations that arise, any other emotions that might be present, and any thoughts that emerge. We can make deliberate decisions about the direction of our life based on these observations. Mindfulness helps us stay the course. It can help bring us back if we have strayed or feel stuck. Contrary to Patrick’s version of “living in the moment,” it’s not about making quick, impulsive, reckless decisions and remaining cut off from our thoughts and emotions. After all, our thoughts and feelings can have really important information for us. Opposite of Patrick: Slow down.

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Once we recognize thoughts that help us to move towards what’s meaningful, we have choices about our actions.

A mindfulness tool we use in Acceptance and Commitment Therapy (ACT), is to look at whether our thoughts and actions are serving the function of moving us TOWARDS our values or are they moving us AWAY from what’s most meaningful. Often life throws up some curve balls. We can decide how we are going to relate to those barriers and take action. For example, using the example from above, if we notice we are unhappy at work, we might start researching other job opportunities, setting up informational interviews, and continuing to show up to work every day (all examples of TOWARDS moves), rather than quitting the next day (an example of an AWAY move), and putting ourselves in a bad position.

What will you decide?

At the end of the episode, Patrick has convinced Spongebob that really living is about engaging in a series of dangerous acts. As they are heading towards their demise, Larry saves them, but only after they are all severely injured. Larry chides them as they are heading towards the sharp rocks, “Look guys, my advice wasn’t meant to be taken literally, I meant to live life to the fullest; not to maim yourselves!” So what will you decide? To live like Patrick and “defeat your reason before you can start;” to live like Spongebob, and not take any chances or go outside your comfort zone; or to live like Larry…where risk is absolutely encouraged but in a calculated deliberate manner?

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Therapy in the Time of COVID-19 and Shelter in Place: What is Teletherapy?

By Annabelle Parr

During this incredibly stressful time of COVID-19, we are having to make major life adjustments.  With the new shelter in place restrictions, you might wonder whether psychotherapy is still an option available to you. The short answer is yes!

Telehealth, also known as video conferencing or online therapy, has been available long before COVID-19, and is an important alternative to in person care.

Traditionally, therapy is done in person. However, with the emergence of new technologies, there have been an increasing number of telehealth / video conferencing options and platforms emerging and available in the mental health field over the last decade. This means that not only do we have the infrastructure available to offer confidential, HIPAA compliant virtual therapy, but also that there is already plenty of research on telehealth and its efficacy in mental health treatment.

Prior to coronavirus, teletherapy expanded access to care to individuals who were not able to get to a therapist’s office, whether that was due to scheduling difficulties or a lack of mental health care options in their community. Now, shelter in place poses a barrier to accessing in person care for all of us. Thus, telehealth via video conferencing offers convenient access to care for everyone as we are required to stay at home as much as possible.

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How effective is telemental health care?

According to the Anxiety and Depression Association of America, “from a large body of research we know that telemental health leads to high patient and provider satisfaction ratings and achieves health outcomes equivalent to in-person care across all diagnostic groups” (Yellowlees, 2020). So as long as the client is willing to engage in therapy virtually and is not an extreme risk to themselves or others, research shows that telemental health is as effective as in person treatment.

How does virtual therapy work?

Typically, telehealth involves video conferencing with your therapist using a secure, HIPAA compliant platform. No extra equipment or complicated applications are required.  Clients can use their smartphones or a laptop computer with a built-in camera. Therapists are able to offer telehealth services to patients located in the state in which they are licensed. So a therapist licensed in and practicing in California is able to offer teletherapy services to patients located in the state of California. Though not all therapists were offering telehealth options prior to COVID-19, given the current situation, many have adjusted their practices to offer video counseling options to patients in need.

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What should you look for in a telehealth provider?

The same things you would look for in a therapist you would see in person: you want to ensure that the therapist you choose has expertise in the areas in which you are seeking treatment for, and you want to make sure the therapist feels like a good fit for you personally. One thing we know for sure is that the quality of the therapist-client relationship is the most important factor in producing successful treatment outcomes across settings, in-person or online. This means that in order for therapy to be effective, you have to have a solid trusting rapport with your therapist. Assuming those two conditions are present, telehealth is likely to be just as effective as working with the same therapist in person.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

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When Panic Sneaks Up and Attacks

by Annabelle Parr 

It’s a regular Thursday morning and John is driving to work along the same stretch of freeway that he drives every day. He is having a stressful week, but his mind isn’t dwelling on anything in particular. His thoughts bounce from what to make for dinner to an errand he has to run during lunch to a meeting he has this afternoon. He doesn’t feel particularly anxious.

Suddenly, his heart starts racing and his palms begin sweating. He can’t explain what is happening; it doesn’t make sense to him. First he feels confused, then he begins to worry that something is wrong. He starts to feel short of breath and then he begins to feel as if he is going to faint. Because he is driving, he is afraid that if he passes out, he will crash and die.

John doesn’t know what happened to him. He worries it may have been a heart attack, but when he goes to the doctor, he learns that it was actually a panic attack. He is confused because he didn’t feel afraid or anxious prior to the attack. His doctor explains that you don’t have to feel panic to experience a panic attack.

Our body is built to respond adaptively to danger.

At some point or another, we have all experienced the feeling that our safety is being threatened. We know what it’s like to feel consciously afraid and to feel our body physiologically preparing for danger. Our heart starts racing, our palms start sweating, our breathing gets shallow, and our muscles tense up. Our body goes into fight-flight-or-freeze mode to help us respond adaptively to whatever threat we are facing.

Panic attacks are the body’s way of trying to prepare us for an unconscious perceived threat.

Sometimes, our body responds to a threat that our conscious mind is not aware of. This is what happened in the above example. When we do not feel afraid, the physiological response itself can feel threatening and overwhelming. This exaggerated and unexplained response can result in a panic attack. Panic attacks create the feeling that your body is turning against you rather than working to help you. What may once have been an adaptive response to an external threat has morphed into what feels like a threat coming from within.

What is a panic attack?

A panic attack is defined as the abrupt onset of intense fear or discomfort that peaks within several minutes. Panic attacks can emerge from a calm state or an anxious one, making them difficult to predict. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V), a panic attack includes at least four of the following symptoms:

  1. Palpitations, pounding heart, or accelerated heart rate
  2. Sweating
  3. Trembling or shaking
  4. Sensations of shortness of breath or smothering
  5. Feelings of choking
  6. Chest pain or discomfort
  7. Nausea or abdominal distress
  8. Feeling dizzy, unsteady, light-headed or faint
  9. Chills or heat sensations
  10. Paresthesia (numbness or tingling sensations)
  11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  12. Fear of losing control or “going crazy”
  13. Fear of dying

What’s the difference between a panic attack and panic disorder?

Panic disorder can develop when a person experiences recurrent and unexpected panic attacks, and develops a persistent concern or worry about additional panic attacks or their consequences and/or significant maladaptive behavior changes related to the attacks. It is possible to experience panic attacks without having panic disorder.

Are panic attacks dangerous?

People experiencing panic attacks often end up in the Emergency Room worried they are having a heart attack. While uncomfortable and overwhelming, a panic attack itself is not dangerous. But because they can arise unexpectedly, it can feel as if they are. If we have just been on a long run or are about to give a big presentation, we know why our heart is pounding or our palms are sweating. But when our heart begins pounding and we start trembling and we can’t figure out why, these symptoms are frightening. They seem to originate within our body rather than as a response to something external.

Is it all in my head?

Absolutely not. While panic attacks are psychologically rooted, they result in a very real physiological response. And though a panic attack may seem to arise out of the blue, there is always an external trigger. Our minds detect a threat, whether consciously or not, and our body responds accordingly. A feedback loop then ensues as our mind interprets our physiological response as threatening, and our body continues to attempt to prepare us to address a threat.

If you experience a panic attack, there is nothing to be ashamed of. It’s not a sign of weakness or that you are going crazy. It’s not your fault. Though it doesn’t feel this way, a panic attack is your body trying to help protect you.

Are panic attacks permanent?

No, panic attacks do not have to be a permanent fixture in your life. Though you do not cause yourself to have a panic attack, you can learn how to prevent and manage them. Panic disorder is one of the most treatable disorders, and Cognitive Behavioral Therapy has been proven to be a highly effective form of treatment.

Cognitive Behavioral Therapy

Psychoeducation and understanding what is happening in the mind and body during a panic attack is a big part of healing. Treatment also involves examining triggers, teaching clients skills to address the acute symptoms of the attack as well as the overall stress level, and using repeated exposures. Exposure therapy incorporates an experiential piece into treatment, where the client is incrementally exposed to the feared situation and learns that they will survive.

Cognitive Behavioral Therapy can help clients to overcome the fear of panic attacks themselves, and empower them to face the situations that they may have previously avoided in order to try to prevent an attack. Clients can learn that not only will they survive a panic attack, but that they can actually move on and begin to thrive.

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If you are experiencing panic attacks, avoiding situations you fear could trigger an attack (driving, crowded spaces, public speaking, etc), or find that your day to day functioning is impacted by anxiety, you could benefit from Cognitive Behavioral Therapy. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

Navigating Guilt

By Annabelle Parr

Feeling guilty is uncomfortable; it’s a sign that something is amiss. Investigating our guilt can help us to discover why it is present. If we have done something wrong, guilt is our conscience pushing us to adjust our behavior or atone for our mistakes. This sort of guilt is useful and exists for good reason.

But it’s also possible to feel guilty even when we haven’t done anything wrong.

Here’s an example: Lily has to tell her staff that they must come to work one Saturday a month. Although this is a company mandate, she feels guilty.

Lily has not done anything wrong, so apologizing or changing her behavior will not address her feelings of guilt in this situation.

How do we move forward and address our feelings of guilt when we have not done anything wrong?

1. Identify the feelings underlying guilt.

When you do something that upsets another person, it brings up emotions in you. You may say, “I feel guilty!” However, Tina Gilbertson says that guilt isn’t so much an emotion as it is a cue that other emotions are present. We can use guilt as an indication that we are experiencing a highly charged emotional reaction, and then we can investigate and identify the emotions that are hidden by our guilt. Paul Gilbert (2003) notes that in order to feel guilt, we may also be required also to tolerate sadness. In investigating the emotions beneath guilt, we are challenged to tolerate the discomfort they bring.

In the example, underlying Lily’s guilt may be frustration with her company for this new mandate and with the fact that she must be the one to deliver the news to her staff. She may also be feeling anxiety about how her staff will react and whether it will negatively impact her relationship with them.

2. Take note of avoidance behaviors and thoughts.

When we are not sure how to address our feelings of guilt, we may try to avoid taking the necessary action that we feel guilty about.

In the example, Lily may put off telling her staff about the new mandate.

In the Healthcare episode of The Office, Michael Scott offers an example of the extreme lengths a person might go to avoid feelings of guilt. Feeling guilty about having to cut employee health care benefits, Michael tries to pass the responsibility along to Jim and then Dwight (two of his employees). As the episode progresses and this avoidance attempt fails, Michael tries to appease everyone with ice cream sandwiches, and then proceeds to lock himself in his office until 5pm.

Source URL: http://www.gettyimages.co.uk/detail/news-photo/health-care-episode-3-aired-pictured-steve-carell-as-news-photo/141187274#health-care-episode-3-aired-04052005-pictured-steve-carell-as-michael-picture-id141187274

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It’s important to remember that avoiding taking action does not assuage our guilt, but rather prolongs it.

3. Have compassion for yourself.

Acknowledge that you are in a difficult situation. Understand that it may be hard to acknowledge your feelings of discomfort. Remember that inevitably, we all disappoint people at some point or another. But it’s okay to feel disappointed, and you don’t have to “fix” other peoples’ disappointment.

In our example, Lily could be self-compassionate by recognizing that it is not her fault that her staff has to work one Saturday a month, and it is not her fault that they will be disappointed. She could say “it’s hard for me to share this news with you and it’s hard for you to hear it.”

4. Act in a way that is fitting to the situation.

Rather than giving in to avoidance, take the actions required of you even though they may be difficult. Part of acting in a way that is fitting means that you are careful not to be too apologetic. Depending on the scenario, you may share your feelings regarding the situation and the challenging position in which you find yourself, but this does not mean that you need to take on the responsibility for the other person’s disappointment or emotional reaction to your action.

For Lily, appropriate action would be holding a meeting with her staff and explaining the new policy. She does not need to apologize, but she can convey a sense of empathy for the reactions that her staff may have.

5. Step back and pause, allowing the other person/people to have their reaction/s.

If the other person is upset by your action, do not rush in to try to “fix” it or apologize. Allow them to feel their emotions, and notice what comes up for you. Have compassion for others and for yourself. And keep in mind that emotions are never permanent, and that we tend to work through them in our own time when we are allowed to feel them.

Lily might allow her staff to ask questions or express dismay. She may display empathy without wavering on the company policy or apologizing.

Guilt can affect our work, our relationships, and our behavior in all aspects of our lives.

Knowing how to navigate the sort of guilt that does not stem from wrongdoing is important. As author and civil rights activist Audre Lorde put it, “guilt is not a response to anger; it is a response to one’s own actions or lack of action. If it leads to change then it can be useful, since it is then no longer guilt but the beginning of knowledge.”

Have you found yourself struggling with a similar situation? Dr. Shea can help with learning the necessary tools to navigate such circumstances. She can be contacted at 619-269-2377.

References:

Gilbert, P. (2003). Evolution, social roles, and the differences in shame and guilt. Social Research:
An international quarterly, 70
(4), 1205-1230.

 

Reframing “Failure”: Trial and Error or Trial and Adjustment?

by Shoshana Shea and Annabelle Parr

How do we learn new things? Trial and error. Error is vital, but it is not the endpoint the way the phrase “trial and error” suggests. Instead, it is a signal that something needs to change. It gives us the information we need to make an appropriate adjustment to our behavior to either improve or redirect ourselves. So life is not really about trial and error, but trial and adjustment.

We embrace error and adjustment with babies.

We don’t expect an infant to come out of the womb knowing how to walk. We recognize that in order to learn, they will fall and get bruised up, and inevitably encounter pain. But we recognize failure as integral to the growth required to walk.

Furthermore, because we don’t expect instant perfection from young children, we recognize, honor, and validate each milestone on the path toward success. If walking is the end goal, then crawling isn’t failure, but rather a necessary step or adjustment towards the ultimate goal.

So why don’t we embrace erring and adjusting in ourselves as adults?

Before we even have language mastered, we are taught to avoid failure.

After we learn to walk and talk, our world shifts. Our culture exalts strength and success, yet ignores the fact that these things only come from failing and growing as a result. So we are taught that it is no longer okay to fail. That now we must present this image that we have life immediately mastered.

We are all busy hiding our mistakes, so it looks like no one is making any.

We don’t want to admit that we make errors, though one of the only things that we can say about life with certainty is that we all make mistakes. We are all trying to make it appear like we only need one trial to succeed – trial and success, never trial and error. We have created this grand cultural illusion that success is instant, fairly effortless, and painless.

We know that failure hurts.

Our instinct is to shield ourselves from that pain. It feels easier to stay well within our comfort zones, never having to feel unsure of the outcome of our efforts. It’s comfortable to be certain that we will succeed because we have aimed lower than our full potential. So we confine ourselves to crawling because we don’t want the bruises that come with learning to walk.

Here’s the harsh truth: we can choose to act on fear, but we cannot avoid failure.

As J.K. Rowling (2008) reminds us, “it is impossible to live without failing at something, unless you live so cautiously that you might as well not have lived at all – in which case, you fail by default.” Failure does hurt, but we can avoid neither failure nor pain in this life. What ultimately harms us more than either of these things is our refusal to try, err, and adjust; our refusal to live and embrace being human.

Source URL: http://likesuccess.com/img4622268

Source URL: http://likesuccess.com/img4622268

Our rejection of failure…

…affects our kids, their education, and their development.

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As soon as our kids enter elementary school, we no longer allow them to fail. An “F” is a terrible thing – a sign of either laziness or lack of intelligence. We teach them to fear failure and to be ashamed of it. They learn to avoid trying new and challenging things because anything less than immediate success is intolerable.  

 …stunts innovation, creativity, and success.

In her TED Talk on shame, Brené Brown (2012) notes that TEDx should be called the failure conference. She means this as a positive thing because the people who achieve truly innovative solutions to the problems in this world are the people who are not afraid to fail, and have courageously done so over and over again.

I can guarantee that every single “successful” person that you admire failed a whole lot before they became the person that you now look up to. Their failures and mistakes helped to shape them into the admirable, wise, resilient human you now look up to.

…bleeds into every important area of our life, from our careers to our relationships to our education to our physical wellbeing.

When we do not allow ourselves to try and to err, we miss out. We limit ourselves from achieving the height of our potential because we are unwilling to face the depth of our imperfection.

When we allow a fear of failure to run our lives, we do not go after that job that is beyond our comfort zone. We do not take on that project that sounds difficult. We do not engage in the vulnerability required to open our hearts and experience real connection. We take the easy class rather than the challenging one. We do not apply to that reach school. We do not walk in to the gym or join that fitness class.

We limit ourselves and our ability to feel joy and confidence because we are afraid to know the other side of that coin. So instead we confine ourselves to the safety of certainty.

The Rock Garden Metaphor

There is a metaphor in Acceptance and Commitment Therapy that offers much wisdom in the way of uncertainty. It is called the Rock Garden Metaphor (Follette & Pistorello, 2007). In Japan, there is a rock garden with fifteen rocks. From any given point in the garden, one rock is always hidden. In order to view the once hidden rock, one must move to a new spot. But there is no point in the garden where all fifteen rocks are within view.

Such is life. We can’t ever have all the knowledge. There is always something we can’t see or we don’t know yet. Maybe what we can’t foresee is failure or heartbreak or loss. But maybe it is success or love or joy. We won’t know until we take a leap to a new position.

So rather than wait for certainty that won’t come, we can cultivate self-awareness, do our best to make decisions in line with who we are and what we value, and take the leap of faith necessary to move forward and find new perspectives. We can evaluate afterwards how it went, what we learned, and if an adjustment is necessary. But we will remain stagnant if we wait to for that hidden rock to show itself or if we wait until we are no longer afraid to move.

Uncertainty is scary. But we don’t need to eliminate fear in order to act.

As Carrie Fisher wisely instructs us, “stay afraid, but do it anyway. What’s important is the action. You don’t have to wait to be confident. Just do it and eventually the confidence will follow.” We don’t eliminate fear by heeding it, but rather by defying it. Thus allowing ourselves to build the kind of enduring confidence that is only born when we risk failure, allow ourselves to fall and gain the knowledge that we can get back up.

Source URL: https://www.pinterest.com/pin/203787951869050945/

Source URL: https://www.pinterest.com/pin/203787951869050945/

Though acting on fear shuts us off from growth, fear itself is not our enemy.

We can be afraid, allow ourselves to feel that fear, and still choose to act in spite of it. As David Richo (1991) put it, “when change and growth scare me, I still choose them. I may act with fear, but never because of it.” Fear is actually a beautiful thing because it gives us the choice to be brave.

We can learn to welcome fear as a positive sign.

As Pema Chodron notes, “fear is a natural reaction to moving closer to the truth.” Rather than trying to eliminate fear, we can embrace it as a companion, a sign that we are moving towards growth and truth.

Source URL: https://www.pinterest.com/pin/394627986073460265/

Source URL: https://www.pinterest.com/pin/394627986073460265/

Error is vital, but it’s the adjustment that’s important.

Ultimately, life is about trial and adjustment, more than trial and error. Error will always be part of the process; however, reframing this statement can help us to acknowledge that failure is not a permanent state of existence. We will inevitably make mistakes, but this is the place where we learn to adjust our behavior. It is the adjustment, the learning, that we should focus on, rather than the error.

Furthermore, even when we do mess up, it is never an error to live our lives. It is never an error to step out of our comfort zone or take that leap of faith. We may try things and we may fail, but it was not an error to fail. It was simply a necessary step in our journey toward becoming the whole person that we are meant to be.

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If you or a loved one might be interested in mindfulness, acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT) for stress, anxiety, depression, trauma, grief, weight, eating, body image, substance use, or challenges related to relationships, work, or other life transitions, Dr. Shoshana Shea can help. If you would like more information or if you are interested in setting up an appointment, please contact her at 619-269-2377 or shoshanashea@gmail.com.

REFERENCES:

Brown, B. (2012). Brené Brown: Listening to shame. [Video file]. Retrieved from https://www.ted.com/talks/brene_brown_listening_to_shame

Follette, V. M., & Pistorello, J. (2007). Finding life beyond trauma: Using acceptance and commitment therapy to heal from post-traumatic stress and trauma-related problems. Oakland, CA: New Harbinger.

Richo, D. (1991). How to be an adult: A handbook on psychological and spiritual integration. Mahwah, NJ: Paulist Press.

Rowling, J. K. (2008). J.K. Rowling: The fringe benefits of failure. [Video file]. Retrieved from https://www.ted.com/talks/jk_rowling_the_fringe_benefits_of_failure

 

When Pain Demands To Be Felt

by Annabelle Parr

We all struggle at some point in our lives. To hurt is to be human, no matter how much we want to avoid it. For most of us, our natural, reflexive reaction is to try to move away from pain. But avoidance will not serve us; it only brings us more anguish in the long run. The response that will serve us best is to feel. As author John Green (2012) wisely put it, pain demands to be felt.

Instead of viewing emotional pain – grief, loss, sadness, anxiety, stress, fear, or even depression – as a threat or as something inherently bad, we can get curious about these feelings, the wisdom they offer, and the purpose they serve. As Rumi reminds us in the poem The Guest House, every emotion is simply a guest. No emotion is ever permanent, but each one serves a purpose. “Each has been sent as a guide from beyond,” so we should learn to sit with each emotion and ask why it is present.  

It can be scary to make contact with the pain that life brings, especially if that is exactly what you have been trying to avoid doing your whole life. It can feel overwhelming and unknown. A therapist can model for you how to approach your pain with mindfulness and compassion, showing you how healing that experience feels, and teaching you to approach yourself and your emotions in the same way. They can help you learn that leaning into the feeling does not mean that the emotion controls you, but rather that you are simply giving it the space it needs to move through you. They can help you to come alongside whatever is causing you pain, and look at it more deeply with you so that you can begin to heal, instead of staying stuck. In fact, the connection that comes from leaning in with someone who profoundly sees and hears you can be incredibly healing.

The more we are able to embrace the pain in our lives, the more deeply we will feel those things that we all desire: love, joy, connection, and peace. Because emotions are not actually opposites, but two sides of the same coin. To know love is to know loss, to know joy is to know sadness, to know connection is to know isolation, and to know peace is to know conflict. And as Brené Brown (2010) reminds us, “you cannot selectively numb emotion. When we numb [hard feelings], we numb joy, we numb gratitude, we numb happiness.”

Here are some tips based on mindfulness and cognitive behavioral therapy for you to begin this process of being with pain, thereby allowing the wisdom inside you to emerge:

  • Practice RAIN (Brach, 2013). This mindfulness acronym can help us to connect to the moment and to our feelings in a meaningful way.
    1. Recognize what is happening. Name your thoughts or emotions, or any feelings or sensations you are experiencing.
    2. Allow life to be as it is. Do not try to suppress or push away the discomfort that may accompany your thoughts or feelings. Simply allow yourself to be as you are.
    3. Investigate with kindness. Connect more deeply with what you are experiencing, using a gentle curiosity to delve into your experience. You might think about how you are experiencing your feelings in your body, or perhaps ask what it is your feelings want from you.
    4. Nonattachment. Rest in the natural awareness that your thoughts and feelings do not define you or your identity.
  • Pick up a good book that offers some helpful wisdom regarding being with our emotions. Here are some suggestions: Constructive Wallowing by Tina Gilbertson, Radical Acceptance by Tara Brach, Daring Greatly by Brene Brown.
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  • Remind yourself that pain is a universal.  No person is impervious, although its content varies by person. Therefore, try not to compare your pain to others.  "Pain, no matter, how large or small, is still painful," and needs our attention.
  • Consider the Acceptance and Commitment Therapy (ACT) concept, "pain can be our ally." When we are hurting, often that pain can remind us of what is most meaningful, and help you to turn your attention to how you can get your values better fulfilled.
  • Practice using compassionate self-talk and self-love. For example, say to yourself “no wonder I feel this way.” Put a hand on your heart, cradle your face, or even give yourself a hug. Small gestures and touch have been shown to be very healing. Try this self-compassion exercise from Kristin Neff if you need a little guidance:

http://self-compassion.org/exercise-2-self-compassion-break/

  • Reach out to a friend or family member for support.
  • Contact a professional if you feel you could benefit from some deeper exploration. 

If you or a loved one might be interested in mindfulness, acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT) for stress, anxiety, depression, trauma, grief, weight, eating, body image, substance use, or challenges related to relationships, work, or other life transitions, Dr. Shoshana Shea can help. If you would like more information or if you are interested in setting up an appointment, please contact her at 619-269-2377 or shoshanashea@gmail.com.

References: 

Brach, T. (2013). Working with difficulties: The blessings of RAIN. Retieved from https://www.tarabrach.com/articles-interviews/rain-workingwithdifficulties/

Brown, B. (2010). Brené Brown: The power of vulnerability. [Video file]. Retrieved from http://www.ted.com/talks/brene_brown_on_vulnerability

Green, J. (2012). The fault in our stars. New York, NY: The Penguin Group.